Although the acute and chronic postoperative pain of surgical patients has gradually been paid attention to, it has not yet been better resolved.and, the incidence of anxiety and depression in cancer patients is constantly increasing，The new analgesic anesthetic esketamine hydrochloride was launched in China last year，however, in the domestic and foreign literature, there are still few reports of esketamine hydrochloride in postoperative analgesia, and most of them are retrospective and small samples.This study aims to investigate whether esketamine has advantages over traditional opioids in terms of postoperative analgesia, anxiety and depression in cancer patients.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
QUADRUPLE
Enrollment
282
By adding different doses of esketamine to the postoperative analgesic pump, and the control group without adding this drug to observe the postoperative pain, anxiety and depression indicators of the surgical patients
By adding different doses of esketamine to the postoperative analgesic pump, and the control group without adding this drug to observe the postoperative pain, anxiety and depression indicators of the surgical patients
No esketamine added
The Second Affiliated Hospital of Zhejiang University anesthesiology department
Hangzhou, Zhejiang, China
Incidence of moderate to severe pain
Visual analog score is 4 points or more
Time frame: Within 72 hours after surgery
Pain score
Visual analog scale
Time frame: Within 72 hours after surgery
Adverse reactions
Nausea, vomiting, lethargy, mental symptoms, etc.
Time frame: Within 72 hours after surgery
Postoperative analgesia
PCIA usage（ml）, PCIA compressions（frequency）, remedial analgesia measures（Name and dosage of intravenous analgesics）
Time frame: Within 48 hours after surgery
Sedation
Ramsay sedation score（The score is 1-6 points, the higher the score, the higher the degree of sedation, the ideal sedation score is 2 points）
Time frame: Within 48 hours after surgery
Anxiety
Hamilton Anxiety Scale（There are a total of 14 options. Each item is divided into 0-4 points according to the degree, and the score is 0-56 points. The total score is ≥29 points, which may be severe anxiety; ≥21 points, there must be obvious anxiety; ≥14 points, there must be Anxiety; more than 7 points, there may be anxiety; if less than 7, there are no anxiety symptoms.）
Time frame: Baseline (Before operation), 24 hours after operation, 72 hours after operation
Depression
Hamilton Depression Scale（There are a total of 17 options, and each item is divided into 0-4 points or 0-2 points according to the degree. The total score is less than 7 points: normal; the total score is 7\~17 points: there may be depression; the total score is 17\~24 points : There must be depression; total score\> 24 points: severe depression）
Time frame: Baseline (Before operation), 24 hours after operation, 72 hours after operation
Sleep condition
Sleep quality（Self-assessment by the patient, the score is 1-5 points, the higher the score, the better the sleep）
Time frame: Within 72 hours after surgery
Chronic pain
Chronic pain conversion rate（Follow-up one month after surgery, if there are still pain symptoms, it is chronic pain）
Time frame: One month after surgery
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